Campbell Macbean, March 2006 - In my last article we looked at the crucial role trust plays in all your dealings with patients. Usually dentists spend much more time developing and honing their clinical, technical skills rather than their interpersonal or Emotional Intelligence (E.I). The trouble is, it is the technical side of things that often makes the least difference in a patients’ decision process. This doesn’t mean that clinical skills are unimportant - just that if they’re developed in isolation from emotional skills, problems arise in patient trust.

Everyone has different E.I strengths and weaknesses. Some people are better communicators, some are better at building rapport. To focus on areas of your E.I. that need attention will probably require a structured individualised approach starting with an E.Q test and coaching. However, there are some easy ways that you can work on your E.I. skills with a general broad-brush approach. In this article, I will give some general E.I. tips that all Dentists can use.

• Keep a fuzzy file on patients – Remembering small details about your patients is important to develop, maintain and re-establish a relationship with patients when they come in. Some dentists have prodigious memories and will recall whether Mrs Brown got a new dog or if her son won the cricket six months ago when they last saw her. Most of us won’t remember details like this without some help. Keep (very brief) notes in their file to jog your memory before you see them.
• Develop your listening skills - You might think listening is something you do every day. Active listening, however, is very different from what we normally think of as day-to-day listening. It requires you to be fully present with the patient, focussed on what they are saying and empathising with them. As a dentist it is especially important to work on your listening skills as you often need to identify patients root concerns.
• Avoid only using closed questions
Dentists tend to ask lots of closed questions to get specific clinical information. These are a bit like the questions you would find in a Medical History form:

Q: “Do you grind your teeth at night?”
A: ”Yes”,

Q: “How long since you’ve had your teeth professionally cleaned?”
A: “A year”.

Questions like these are only effective for getting you specific information fast and offer a very limited way of communicating with your patients.

Using some open-ended questions, - those that can’t be answered in one or a few words - will help you build and maintain rapport with patients and encourage them to provide you with maximum information about what’s going on for them dentally.

For some dentists the first time they spend extra time on a patient is when they have to do a big ‘song-and-dance’ complex treatment plan for them. I believe this approach puts the effort at the wrong stage of the dentist/patient relationship and will often lead to poor case acceptance.

If the first time you try to build rapport with a patient is when you want them to accept a big case proposal, it is going to be an uphill battle. They are going to be questioning your motives for being nice.

It may be counter-intuitive, but if you are trying to build your case acceptance, you’re actually better off spending more time on the beginning of the patient’s experiences with your practice and you as a dentist. So, if you spend time building rapport and showing patients that you are interested in them from the beginning, by the time a case presentation is necessary your relationship should be well developed and natural.

Obviously if you have a new patient coming into the practice in pain, this is clearly not the time for major relationship building. It is essential to get them out of pain and then bring them back for a new patient consult. You can’t adequately build trust with someone in physical pain.

Am I Hungry? If you haven’t eaten breakfast and you’ve worked through lunch, what impact is this having on you, your behaviour and your patience levels? Dentists often say they get used to not having lunch, but not attending to this basic physiological need has potentially highly negative flow on effects if it is a regular occurrence.

Am I Angry? No matter what caused it, having an angry outburst with patients, or worse with staff in front of patients, is bad for business and is likely to be counter productive in other aspects of your life. If you have a short fuse and you recognise this is a problem then speak to a professional about getting some help.

Am I Tired? If you’ve been up late for a few nights, it’s going to have an impact on your clinical skills, concentration levels and patience with the various little details that disrupt a dentist’s routine. If you’ve got young babies at home then you have an excuse and my sympathy! For everyone else, get some early nights! If sleep is an issue, perhaps ask your GP on what you can do.

Also crucial to showing empathy and warmth is vocal quality. Vary your pitch and keep your comments congruent with your body language. What’s the point of having a nice vocal tone if your neck is twitching, your face flushed and your eyes are anywhere but on the patient in front of you? Finally, a willingness to touch (in appropriate situations and in the neutral zone between elbow and shoulder) can show respect and warmth.

When a client starts with Prime they complete an E.Q test to identify their strengths and weaknesses. Through a mix of E.I. goal setting, coaching and a commitment to improvement, I have seen huge changes in these dentists’ Emotional Intelligence. These changes are always reflected in their increased case acceptance, decreased stress levels and improvements in their relationships’ with patients and staff.

Try practicing these skills and see what results you get. A key point is that these ‘soft’ skills have been shown time and again to have a major bottom line result. Higher E.I. skills result in higher trust from patients. Patients who trust you implicitly are more likely to want comprehensive treatment. Moreover, a better E.I. is a great starting point for you to gain a greater sense of personal control in successfully negotiating the ups and downs of life.

• Spend time building patient relationships
• Do the H.A.L.T.S. to check in with yourself throughout the day: This is an acronym for Hungry, Angry, Lonely, Tired and Sad. Doing the HALTS is an excellent tool for developing better emotional self-awareness. There isn’t time to go into every aspect but I’ll discuss three of them briefly.
• Show Empathy: Empathy is a big subject with lots of different facets. One important aspect of it is warmth, and the easiest way to show this is through non-verbal means – i.e. body language. Have an open posture (sit facing them at their level without a mask on). Keep eye contact. Smile. This can be tough if you’ve had two cancellations and squeezed in an emergency. For a busy dentist, showing warmth needs good self-awareness. With self-awareness you can assess your current state (maybe use the HALTS), take a few deep breaths and enter the room calmly. If you are smiling and calm when you meet a patient, it allows them to form a positive first impression.

[Published in Australasian Dentist, Autumn 2006]